Provider Demographics
NPI:1851446165
Name:KENNEDY, ROXANNE M (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:ROXANNE
Middle Name:M
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1102
Mailing Address - Country:US
Mailing Address - Phone:267-980-2374
Mailing Address - Fax:215-497-9762
Practice Address - Street 1:340 E MAPLE AVE STE 207
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-2852
Practice Address - Country:US
Practice Address - Phone:267-980-2374
Practice Address - Fax:215-497-9762
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0133441041C0700X
NJ44SC052630001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical